Gout drug does not improve outcomes for heart disease patients
Published on 10 October 2022
A gout drug does not possess any benefits for ischaemic heart disease patients, a major University of Dundee study has concluded.
A research project spanning seven years has found that allopurinol failed to reduce the primary endpoint of non-fatal myocardial infarction, stroke or cardiovascular death in patients with ischaemic heart disease.
The ALL-HEART study, led by Dundee experts and funded by the National Institute for Health and Care Research (NIHR), analysed results from more than 5,000 patients across the UK. Its findings have been published in The Lancet.
The study’s principal investigator, Professor Isla Mackenzie, said, “The ALL-HEART study has shown that allopurinol therapy does not improve major cardiovascular outcomes in patients with ischaemic heart disease.
“Allopurinol is already widely used in patients with gout to prevent acute flares, and many of these patients have co-existing ischaemic heart disease. The question of whether allopurinol might prevent cardiovascular events in people with heart disease, but no clinical gout, has been around for many years and we are pleased to have now definitively answered this question for patients and doctors in a robust study.”
Previous studies had shown allopurinol to display cardiovascular benefits, with patients living with angina or coronary artery disease enjoying increased exercise time and reduced chest pain as results of taking the drug.
This suggestion of anti-ischaemic activity prompted investigators behind the ALL-HEART study to determine whether allopurinol could improve cardiovascular outcomes in patients with ischaemic heart disease.
A total of 5,721 patients featured in the study, all over the age of 60 and with ischaemic heart disease, but no history of gout. The average age of participants was 72 years, with 76% of the cohort male. The group was randomly split into two, with one receiving a daily dose of allopurinol and the other receiving regular care.
The trial concluded that there was no evidence of different health outcomes between patients in the two groups, ruling out allopurinol as a beneficial form of medication for those living with ischaemic heart disease. The findings also revealed no difference between the groups in the secondary study outcomes, including cardiovascular death, hospitalisation for heart failure, and all cardiovascular hospitalisations.
“Managing heart disease is incredibly important for patients and exploring potential treatments and therapies that could improve quality of life is an important topic of research,” added Professor Mackenzie.
“While this news will undoubtedly be disappointing for those living with ischaemic heart disease, ALL-HEART has at least been able to offer clarity on the effectiveness of allopurinol. It means that new avenues of research can now be explored in the quest to help those living with one of the most pressing health issues in our society.”
The ALL-HEART study was funded by the National Institute for Health Research (NIHR) and was jointly sponsored by the University of Dundee and NHS Tayside.
The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:
• Funding high quality, timely research that benefits the NHS, public health and social care;
• Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;
• Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;
• Attracting, training and supporting the best researchers to tackle complex health and social care challenges;
• Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;
• Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries.
NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK Aid from the UK government.
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